Fall-related allegations continue to be the most common type of professional liability claim skilled nursing facilities face – making up 36.1% of all claims.
That’s according to the 2022 Aging Services Claims Report released by CNA (NYSE: CNA) this week, now in its 11th edition.
The analysis in the report is based on 2,265 aging services professional liability claims that closed between Jan. 1, 2018 and Dec. 31, 2020. Skilled nursing made up 1,728 of those claims.
While the study showed a broad increase in the average cost of claims across all care settings since the 2018 report, the average cost of claims in assisted living ($267,174) continues to exceed that of skilled nursing facilities ($245,559) in the data set.
However the average cost of fall-related claims in the skilled nursing setting was shown to have seen a sharp increase, driven in part by allegations of improper care, according to the report.
SNFs paid an average of $223,637 for fall-related claims, compared to $187,774 in the 2018 report.
Combined, fall and pressure injury-related allegations account for approximately 65% of all claims in the skilled nursing setting, demonstrating that the industry continues to struggle with managing these sources of liability.
The highest severity allegations included elopement, unsafe environment, resident abuse and failure to inform a physician of change or new conditio, according to the report.
Monitoring fall history was shown to provide additional insight for operators in preventing future falls and is a recommended risk management tool moving forward.
However, a lack of appropriate staffing may contribute to or exacerbate allegations of failure to monitor and may lead to an increase in unwitnessed falls or delayed identification of pressure injuries, according to the report.
Residents with a previous fall made up 62.2% of the death claims while patients with no fall history made up just 34.8%. Dementia is also considered to be a contributing factor in fall-related closed claims.
“Adopt a formal disclosure policy and procedure with documentation guidelines in order to consistently communicate fall facts and changes in the care place,” the authors note. “An effective fall-reduction plan may help curb the rise in claim severity.
Aging in place arrangements, which permit residents to reside in one location as their care needs evolve, do not come without risks, according to the report.
Resident injury, allegations of unsafe resident retention and other unintended liability exposures were listed as possible outcomes when resident care needs exceed available resources. In the event that an admitted resident later requires a higher level of care, the reason should be documented and safe arrangements provided while a solution is found, the report recommends.
